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目的 评价双螺旋CT薄层增强 3期扫描在小肝癌诊断中的价值。方法 分析 1 0 0例患者采用双螺旋CT薄层增强 3期扫描(triple- phaseduplex -helicalCT ,TDHCT)检出≤ 30mm小肝癌 (smallhepatocellularcarcinoma ,SHCC) 76个CT图像 ,由有经验的CT室医生通过医学影像工作站 (MIW )和医学影像存储与传输系统 (PACS)的医学图像浏览终端 ,分析、统计SHCC各时相病灶强化类型 ,计算检出率。依SHCC的典型表现 ,即动脉期高密度、门静脉期和延迟期为等或低密度 ,做出诊断。结果 76个SHCC在 3期扫描中的动脉期、门静脉期和延迟期检出率分别为 86 .8% (66 76)、61 .8% (47 76)、93 .4 % (71 76)。 77.6 % (59)的小肝癌在动脉期呈高密度 ,54 % (41 )在门静脉呈低密度 ,93 .4 % (71 )在延迟期呈低密度。结论 大多数的SHCC在 3期薄层扫描中为典型表现。SHCC定性诊断主要依靠其自身动态强化特点 ,双螺旋CT薄层增强 3期扫描能提高SHCC的检出率 ,TDHCT可提高SHCC诊断和鉴别诊断能力。
Objective To evaluate the value of double-helical CT enhanced thin-section three-phase scans in the diagnosis of small hepatocellular carcinoma. Methods Totally 76 CT images of ≤30 mm small hepatocellular carcinoma (SHCC) were detected by double-helical CT scan with triple-phase duplex-technique (TDHCT). The CT images were obtained from experienced CT physicians Medical Imaging Workstation (MIW) and medical image storage and transmission system (PACS) medical image browsing terminal to analyze and count the types of SHCC enhancement in each phase and calculate the detection rate. According to the typical performance of SHCC, arterial phase of high density, portal phase and delay of equal or low density, to make a diagnosis. Results The detection rates of 76 SHCCs during the arterial phase, portal vein phase and delayed phase were 86.8% (66 76), 61.8% (47 76) and 93.4% (71 76) respectively in 3 stages. Small hepatic cancers in 77.6% (59%) showed high density in the arterial phase, 54% (41%) showed low density in the portal vein and 93.4% (71%) showed low density in the delayed phase. Conclusions Most of the SHCCs are a typical manifestation in 3-stage TLC. The qualitative diagnosis of SHCC relies on its own dynamic enhancement characteristics. Double-helical CT thin-layer enhanced three-phase scanning can improve the detection rate of SHCC. TDHCT can improve the diagnostic and differential diagnosis ability of SHCC.